EP1611858A1 - Medical instrument for electrosurgery - Google Patents

Medical instrument for electrosurgery Download PDF

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Publication number
EP1611858A1
EP1611858A1 EP05001771A EP05001771A EP1611858A1 EP 1611858 A1 EP1611858 A1 EP 1611858A1 EP 05001771 A EP05001771 A EP 05001771A EP 05001771 A EP05001771 A EP 05001771A EP 1611858 A1 EP1611858 A1 EP 1611858A1
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EP
European Patent Office
Prior art keywords
wire
loop
pivot axis
electrode
instrument
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Granted
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EP05001771A
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German (de)
French (fr)
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EP1611858B1 (en
Inventor
Fridolin Anders
Hubert Brückler
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Karl Storz SE and Co KG
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Karl Storz SE and Co KG
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Publication of EP1611858A1 publication Critical patent/EP1611858A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B32—LAYERED PRODUCTS
    • B32B—LAYERED PRODUCTS, i.e. PRODUCTS BUILT-UP OF STRATA OF FLAT OR NON-FLAT, e.g. CELLULAR OR HONEYCOMB, FORM
    • B32B25/00—Layered products comprising a layer of natural or synthetic rubber
    • B32B25/10—Layered products comprising a layer of natural or synthetic rubber next to a fibrous or filamentary layer

Definitions

  • the invention relates to a medical instrument for electrosurgery, comprising a tubular shaft, with at least one jaw part movable about a pivot axis relative to the tubular shaft at the distal end of the tubular shaft, wherein the at least one movable jaw part has an electrode, and with one to the electrode of the at least one movable jaw part leading power supply, which is formed as a wire-shaped element whose distal end is connected to the electrode.
  • Such an instrument is used, for example, for performing endoscopically assisted interventions in the human or animal body in the context of minimally invasive surgery.
  • an electrosurgical medical instrument of the present invention biological tissue may be cut and / or coagulated under the influence of high frequency current.
  • two jaw parts are arranged, of which at least one is movable, wherein the present invention is particularly advantageous in those medical instruments in which both jaw parts are movable.
  • the jaws are formed as cutting tools with cutting edges to separate tissue in the body, or as grasping tools with correspondingly butting surfaces to capture separated tissue with the jaws and remove it from the body, or to to hold an organ or a vessel to relocate it from the operating area.
  • the jaws can also have a combination of a cutting and a barrel function.
  • the instrument has two jaw parts, at least one of the two jaw parts is pivotally connected to the tubular shaft, while the other jaw part is connected to the tubular shaft rigid or also articulated.
  • both jaw parts each have an electrode which can be acted upon by high-frequency current and has different polarities. Accordingly, both electrodes of the two jaw parts can be connected separately to one pole each of a high-frequency voltage source.
  • the cutting effect can be increased by the thermal effect of high frequency current in the tissue, on the other hand, in the case of training as a drum tool between the mouth parts taken tissue coagulated by the heat and bleeding of the tissue to be breastfed.
  • the power supply to the at least one electrode of the at least one movable jaw part regularly presents a problem.
  • the two jaw parts must be sufficiently electrically insulated from one another in the region of the joint forming the pivot axis of the at least one jaw part.
  • An electrical separation of the two jaw parts in the region of the joint is required, in particular in bipolar instruments, since the electrodes of the two jaw parts are placed at different potentials.
  • the problem of the electrical separation of the two jaw parts from one another is the greater, the smaller such an instrument is in the area of the jaw parts and thus in the area of the joint.
  • a slimline design However, the instrument in the field of jaw parts is particularly important for minimally invasive surgery.
  • both jaw parts are provided at the distal end, of which only one is movable, both jaw parts each having a metallic base body, which are hinged together in the region of the pivot axis.
  • the metallic base bodies On their side facing each other, the metallic base bodies each have an insulator element to which the respective electrode of the respective jaw part is attached, so that the electrodes are electrically separated from the metallic base body.
  • the power supply lines are formed as wire-shaped elements and are insulated from each other.
  • Disadvantage of this embodiment is the type of power supply to the respective electrode in the form of the straight, wire-shaped element.
  • the wire-shaped element When opening and closing the jaw parts, that is, when moving the at least one movable jaw part, the wire-shaped element is permanently bent and stretched again.
  • These load changes over the life of the instrument lead relatively quickly to a fatigue breakage of the wire-shaped element in the region of the pivot axis, whereby the instrument does not reach a long service life, that is, the life of this instrument is undesirably shortened.
  • a sliding contact has been provided for the at least one movable jaw part, which picks up the current at the pivot axis of the at least one movable jaw part forming the joint, wherein the power supply ends accordingly at the joint.
  • the provision of a sliding contact in the region of the joint is structurally very complex, and very difficult to implement in particularly small-sized instruments.
  • an electrosurgical, in particular bipolar medical instrument which has two jaw parts, one of which is movable.
  • the two jaw parts have in the region of their articulated connection to a base body made of an electrically insulating material, to which a the corresponding electrode forming electrically conductive jaw part insert is attached.
  • the second jaw part were designed to be movable as well, the same problem would exist as with the known instrument described above, namely that the wire-shaped element would be permanently subjected to bending and stretching, which in turn would lead to breakage of the wire-shaped element.
  • the invention is therefore based on the object, a medical instrument of the type mentioned in such a way that the life of the instrument is increased.
  • this object is achieved with regard to the above-mentioned medical instrument in that the wire-shaped element is formed in the region of the pivot axis as a loop.
  • the medical instrument instead of passing the wire-shaped element substantially straight on the joint forming the pivot axis, as in the case of the known instrument, it is provided in the medical instrument according to the invention to form a loop in the region of the pivot axis which compensates the length during pivoting of the at least one movable element Secured jaw part about the pivot axis.
  • the wire-shaped element When swinging back and forth of the at least one movable jaw part when using the instrument, the wire-shaped element is thus no longer permanently subjected to bending, because the permanent change in angle of the at least one movable jaw part relative to the shaft passed to the loop and from this in a length increase or Length decrease is converted to the circumference of the loop.
  • the loop acts like a kind of torsion spring.
  • the loop extends over at least about a semicircle.
  • This measure has the advantage that the total length of the wire-shaped element is only slightly increased compared to a straight-line wire-shaped element, and on the other hand in medical instruments, in which the at least one movable jaw part passes through only a small maximum pivot angle, is sufficient to bring about the effect according to the invention as described above.
  • the loop extends over at least one full circle.
  • the wire-shaped element has at least one complete turn.
  • the proximal and distal ends of the wire-shaped element in this embodiment form a kind of leg spring as in a clothespin, but for the purposes of the present invention one turn is sufficient as a spiral or coil spring, but more turns may be provided.
  • the loop is resilient.
  • the wire-shaped element is formed at least in the region of the loop of a resilient material, for example. From spring steel. However, a certain spring elasticity already results from the bent configuration of the wire-shaped element as a loop and can be enhanced by the aforementioned choice of material.
  • the spring elasticity of the loop can advantageously support the pivoting of the at least one movable jaw part, for example, either the opening movement or the closing movement of the at least one movable jaw part.
  • the loop is arranged around the pivot axis.
  • the above measure has the advantage that the loop can be arranged at this point without additional space.
  • the further advantage of this measure is that the wire-shaped element in the region of the pivot axis is subjected to the greatest bending stress, and thus the length compensation effected by the loop comes into its own.
  • a proximal end of the wire-shaped element is fixed to the tubular shaft and conductively connected thereto.
  • This measure has the advantage that the tubular shaft can be used as power supply line as in the known instrument.
  • the proximal end of the wire-shaped element can be fixed in the region of the distal end of the tubular shaft, which has the further advantage that the wire-shaped element does not have to be guided completely through the tubular shaft to the proximal, which simplifies the assembly of the instrument according to the invention.
  • a second movable jaw part is arranged at the distal end of the tubular shaft, which is pivotable about the pivot axis and has a second electrode, and an axially movable force transmission element of an actuating mechanism for moving the two Jaw parts serves as power supply line for the second electrode.
  • the advantageous effects of the present invention come into play especially since there is a power supply for both electrodes of the two movable jaw parts, in which a bending stress and thus a risk of breakage is avoided.
  • the two jaw parts are insulated from each other in the region of the pivot axis.
  • Such insulation may be provided as in the instrument known from document WO-A-01/15614 in which the jaw parts, or at least one of the two jaw parts, in the region of the pivot axis has a base body made of an electrically insulating material.
  • a rivet or pin which forms the pivot axis, metallic and thus be carried out particularly stable, since on the insulating body electrical separation of the two jaw parts is accomplished from each other.
  • Fig. 1 is provided with the general reference numeral 10 medical instrument for electrosurgery.
  • Fig. 2 further details of the instrument 10 are shown in more detail.
  • the instrument 10 is used in the context of minimally invasive surgery for the treatment of tissue in the human or animal body for preparation by means of high-frequency current.
  • the instrument 10 is in the embodiment shown a barrel instrument, more precisely a forceps, can be taken with the tissue and coagulated.
  • the instrument 10 is also a bipolar instrument, as will be explained in more detail below.
  • the instrument 10 has an elongate tubular shaft 12.
  • the tubular shaft 12 is formed as a current conductor metallic tube, which is surrounded by an insulating sheath.
  • a first jaw part 14 and a second jaw part 16 are arranged.
  • the first jaw member 14 and the second jaw member 16 are both movable relative to the tubular shaft 12 about a pivot axis 18, that is pivotable.
  • the jaws 14 and 16 are shown with respect to their closed position by solid lines, and with respect to their open position with broken lines.
  • the jaw members 14 and 16 are mounted in the region of the pivot axis 18 on an insulator piece 20 made of plastic or ceramic, which in turn is connected to the tubular shaft 12.
  • a handle 22 is arranged, which has two handle parts 24 and 26.
  • the grip parts 24 and 26 are pivotally connected to each other pivotally about a pivot axis 28 relative to each other, wherein the relative movement of the handle parts 24 and 26 serves to open and close the jaws 14 and 16.
  • connection 30 for connecting the instrument 10 to a non-illustrated high-frequency current generator is arranged on the handle 22.
  • the tubular shaft 12 is also rotatable about its longitudinal axis, for which purpose a rotary handle 32 at the distal end of the handle 22 is arranged for actuation.
  • an axially movable force transmission element 34 which is shown in Fig. 2 in the region of its distal end, and the proximal end of one of the two handle parts 24 and 26 is positively connected .
  • the Power transmission element 34 is connected via a toggle mechanism 36, 38, 40 with two jaws 14 and 16.
  • An axial movement of the force transmission element 34 is used for opening and closing, that is, the pivoting of the jaws 14 and 16 about the pivot axis 18th
  • the pivot axis 18 is, for example, formed by a transverse to the longitudinal direction of the shaft 12 extending rivet or journal.
  • the jaw part 14 has an electrode 42
  • the jaw part 16 has an electrode 44, wherein the electrodes 42 and 44 form the distal end of the jaw parts 14 and 16, respectively.
  • the jaw part 14 has a base body 46 made of insulating material and the jaw part 16 has a base body 48 also made of insulating material. In this way, the jaws 14 and 16 are electrically isolated from each other in their proximal region.
  • a power supply line for the electrode 42 of the jaw part 14 is a wire-shaped element 50, whose proximal end is connected to the formed as a current conductor tubular shaft 12, for example.
  • the electrode 42 can thus be connected to a first pole of the high-frequency current generator.
  • a distal end 54 of the wire-shaped element 50 is conductively connected to the electrode 42.
  • the wire-shaped element 50 is formed as a loop 56 which is arranged around the pivot axis 18 around.
  • the loop 56 is formed in the present embodiment in that the wire-shaped element 50 is placed about one and a half times about the pivot axis 18, and thus has at least one turn.
  • the loop 56 causes a length compensation during the opening and closing of the jaw part 14, wherein the wire-shaped element 50 is subjected to much less bending or stretching.
  • the loop 56 thus extends over at least one full circle, however, the loop 56 may extend only over at least about one semicircle, if that satisfies the requirements.
  • the loop 56 is in particular spring-elastic, for which purpose the wire-shaped element 50 is formed, at least in the region of the loop 56, from a resilient, electrically conducting material, in particular from spring steel.
  • the electrode 44 of the second jaw part 16 is connected to the other pole of the high-frequency generator via the force transmission element 34, which is correspondingly electrically conductive, the current transmission from the force transmission element 34 taking place via the toggle mechanism 36, 40, as described in the document WO-A -01/15614 is, the disclosure of which is expressly incorporated herein by reference.

Abstract

The device (10) is designed as a shaft (12) with two handles (24, 26) attached to its upper end and two movable gripping and/or cutting elements (14, 16) situated at its lower end. A lead in the shape of a wire is guided through the shaft (12) to an electrode located at each of the elements (14, 16) in order to facilitate a coagulation or removal of tissue using electric power. The wire is guided around the rotation axle (18) at the lower end, forming a loop preventing the wire from being bent and stretched excessively during an operation.

Description

Die Erfindung betrifft ein medizinisches Instrument für die Elektrochirurgie, mit einem Rohrschaft, mit zumindest einem um eine Schwenkachse relativ zum Rohrschaft beweglichen Maulteil am distalen Ende des Rohrschafts, wobei das zumindest eine bewegliche Maulteil eine Elektrode aufweist, und mit einer zu der Elektrode des zumindest einen beweglichen Maulteils führenden Stromzuleitung, die als drahtförmiges Element ausgebildet ist, dessen distales Ende mit der Elektrode verbunden ist.The invention relates to a medical instrument for electrosurgery, comprising a tubular shaft, with at least one jaw part movable about a pivot axis relative to the tubular shaft at the distal end of the tubular shaft, wherein the at least one movable jaw part has an electrode, and with one to the electrode of the at least one movable jaw part leading power supply, which is formed as a wire-shaped element whose distal end is connected to the electrode.

Ein derartiges Instrument ist aus dem Dokument WO-A-00/36986 bekannt.Such an instrument is known from document WO-A-00/36986.

Ein solches Instrument wird bspw. zur Durchführung endoskopisch gestützter Eingriffe im menschlichen oder tierischen Körper im Rahmen der minimal-invasiven Chirurgie verwendet.Such an instrument is used, for example, for performing endoscopically assisted interventions in the human or animal body in the context of minimally invasive surgery.

Mit einem elektrochirurgischen medizinischen Instrument der vorliegenden Erfindung kann biologisches Gewebe unter dem Einfluss von Hochfrequenzstrom geschnitten und/oder koaguliert werden. Üblicherweise sind am distalen Ende des Rohrschafts zwei Maulteile angeordnet, von denen zumindest eines beweglich ist, wobei die vorliegende Erfindung besonders vorteilhaft bei solchen medizinischen Instrumenten ist, bei denen beide Maulteile beweglich sind. Je nach dem chirurgischen Verwendungszweck eines solchen Instruments sind die Maulteile als Schneidwerkzeuge mit Schneidkanten ausgebildet, um Gewebe im Körper abzutrennen, oder als Fasswerkzeuge mit entsprechend stumpf aufeinander stoßenden Flächen, um abgetrenntes Gewebe mit den Maulteilen zu fassen und aus dem Körper zu entfernen, oder um ein Organ oder ein Gefäß zu halten, um dieses aus dem Operationsgebiet zu verlegen. Die Maulteile können auch eine Kombination aus einer Schneid- und einer Fassfunktion aufweisen.With an electrosurgical medical instrument of the present invention, biological tissue may be cut and / or coagulated under the influence of high frequency current. Usually, at the distal end of the tubular shaft two jaw parts are arranged, of which at least one is movable, wherein the present invention is particularly advantageous in those medical instruments in which both jaw parts are movable. Depending on the surgical use of such an instrument, the jaws are formed as cutting tools with cutting edges to separate tissue in the body, or as grasping tools with correspondingly butting surfaces to capture separated tissue with the jaws and remove it from the body, or to to hold an organ or a vessel to relocate it from the operating area. The jaws can also have a combination of a cutting and a barrel function.

Wenn das Instrument zwei Maulteile aufweist, ist zumindest eines der beiden Maulteile gelenkig mit dem Rohrschaft verbunden, während das andere Maulteil mit dem Rohrschaft starr oder ebenfalls gelenkig verbunden ist.If the instrument has two jaw parts, at least one of the two jaw parts is pivotally connected to the tubular shaft, while the other jaw part is connected to the tubular shaft rigid or also articulated.

Bei einem medizinischen Instrument der eingangs genannten Art ist es weiterhin vorgesehen, dass zumindest ein Maulteil eine mit Hochfrequenzstrom beaufschlagbare Elektrode aufweist. Wenn das Instrument als bipolares elektrochirurgisches Instrument ausgebildet ist, was im Rahmen der vorliegenden Erfindung ebenfalls bevorzugt ist, weisen beide Maulteile jeweils eine mit Hochfrequenzstrom beaufschlagbare Elektrode mit unterschiedlichen Polaritäten auf. Beide Elektroden der beiden Maulteile können dementsprechend getrennt voneinander mit jeweils einem Pol einer Hochfrequenzspannungsquelle verbunden werden. Durch Beaufschlagen der Elektroden der beiden Maulteile kann einerseits im Falle der Ausbildung als Schneidwerkzeug die Schneidwirkung durch die thermische Wirkung des Hochfrequenzstroms im Gewebe erhöht werden, andererseits kann im Falle einer Ausbildung als Fasswerkzeug zwischen den Maulteilen gefasstes Gewebe durch die Wärmeentwicklung koaguliert und eine Blutung des Gewebes damit gestillt werden.In a medical instrument of the type mentioned, it is further provided that at least one jaw part a Having high-frequency current acted upon electrode. If the instrument is designed as a bipolar electrosurgical instrument, which is likewise preferred in the context of the present invention, both jaw parts each have an electrode which can be acted upon by high-frequency current and has different polarities. Accordingly, both electrodes of the two jaw parts can be connected separately to one pole each of a high-frequency voltage source. By applying the electrodes of the two jaw parts on the one hand in the case of training as a cutting tool, the cutting effect can be increased by the thermal effect of high frequency current in the tissue, on the other hand, in the case of training as a drum tool between the mouth parts taken tissue coagulated by the heat and bleeding of the tissue to be breastfed.

Bei derartigen elektrochirurgischen medizinischen Instrumenten stellt sich die Stromzuführung zu der zumindest einen Elektrode des zumindest einen beweglichen Maulteils regelmäßig als problematisch dar. Insbesondere bei bipolaren Instrumenten müssen die beiden Maulteile im Bereich des die Schwenkachse des zumindest einen Maulteils bildenden Gelenks ausreichend elektrisch gegeneinander isoliert sein. Eine elektrische Trennung der beiden Maulteile im Bereich des Gelenks ist insbesondere bei bipolaren Instrumenten erforderlich, da die Elektroden der beiden Maulteile an unterschiedliche Potenziale gelegt werden. Das Problem der elektrischen Trennung der beiden Maulteile voneinander stellt sich als um so größer dar, je kleiner ein derartiges Instrument im Bereich der Maulteile und damit im Bereich des Gelenks ausgebildet ist. Eine schmalbauende Ausgestaltung des Instruments im Bereich der Maulteile ist jedoch für die minimal-invasive Chirurgie besonders wichtig.In such electrosurgical medical instruments, the power supply to the at least one electrode of the at least one movable jaw part regularly presents a problem. In bipolar instruments in particular, the two jaw parts must be sufficiently electrically insulated from one another in the region of the joint forming the pivot axis of the at least one jaw part. An electrical separation of the two jaw parts in the region of the joint is required, in particular in bipolar instruments, since the electrodes of the two jaw parts are placed at different potentials. The problem of the electrical separation of the two jaw parts from one another is the greater, the smaller such an instrument is in the area of the jaw parts and thus in the area of the joint. A slimline design However, the instrument in the field of jaw parts is particularly important for minimally invasive surgery.

Bei dem aus dem oben genannten Dokument WO-A-00/36986 bekannten Instrument sind am distalen Ende zwei Maulteile vorgesehen, von denen nur eines beweglich ist, wobei beide Maulteile jeweils einen metallischen Grundkörper aufweisen, die im Bereich der Schwenkachse miteinander gelenkig verbunden sind. Die metallischen Grundkörper weisen auf ihrer einander zugewandten Seite jeweils ein Isolatorelement auf, an denen die jeweilige Elektrode des jeweiligen Maulteils angebracht ist, so dass die Elektroden vom metallischen Grundkörper elektrisch getrennt sind. Zu jeder der beiden Elektroden verläuft über das Gelenk hinweg eine Stromzuleitung, wobei die Stromzuleitungen als drahtförmige Elemente ausgebildet sind und voneinander isoliert sind. Bei diesem Aufbau der Maulteile ist es möglich, die Maulteile im Bereich des Gelenks metallisch und damit besonders stabil auszugestalten.In the instrument known from the above-mentioned document WO-A-00/36986, two jaw parts are provided at the distal end, of which only one is movable, both jaw parts each having a metallic base body, which are hinged together in the region of the pivot axis. On their side facing each other, the metallic base bodies each have an insulator element to which the respective electrode of the respective jaw part is attached, so that the electrodes are electrically separated from the metallic base body. To each of the two electrodes extends across the joint across a power supply line, wherein the power supply lines are formed as wire-shaped elements and are insulated from each other. In this construction of the jaw parts, it is possible to design the jaw parts in the region of the joint metallic and thus particularly stable.

Nachteil dieser Ausgestaltung ist die Art der Stromzuführung zu der jeweiligen Elektrode in Form des gerade verlaufenden, drahtförmigen Elements. Beim Öffnen und Schließen der Maulteile, das heißt beim Bewegen des zumindest einen beweglichen Maulteils, wird das drahtförmige Element permanent gebogen und wieder gestreckt. Diese über die Lebensdauer des Instruments gesehen ständigen Lastwechsel führen relativ rasch zu einem Ermüdungsbruch des drahtförmigen Elements im Bereich der Schwenkachse, wodurch das Instrument keine hohen Standzeiten erreicht, das heißt, die Lebensdauer dieses Instruments ist unerwünscht verkürzt.Disadvantage of this embodiment is the type of power supply to the respective electrode in the form of the straight, wire-shaped element. When opening and closing the jaw parts, that is, when moving the at least one movable jaw part, the wire-shaped element is permanently bent and stretched again. These load changes over the life of the instrument lead relatively quickly to a fatigue breakage of the wire-shaped element in the region of the pivot axis, whereby the instrument does not reach a long service life, that is, the life of this instrument is undesirably shortened.

Zur Behebung dieses Problems hat man daher für das zumindest eine bewegliche Maulteil einen Schleifkontakt vorgesehen, der den Strom am die Schwenkachse des zumindest einen beweglichen Maulteils bildenden Gelenk abgreift, wobei die Stromzuleitung entsprechend am Gelenk endet. Das Vorsehen eines Schleifkontakts im Bereich des Gelenks ist jedoch konstruktiv sehr aufwändig, und bei besonders kleinbauenden Instrumenten sehr schwierig zu realisieren.To remedy this problem, therefore, a sliding contact has been provided for the at least one movable jaw part, which picks up the current at the pivot axis of the at least one movable jaw part forming the joint, wherein the power supply ends accordingly at the joint. However, the provision of a sliding contact in the region of the joint is structurally very complex, and very difficult to implement in particularly small-sized instruments.

Aus dem Dokument WO-A-01/15614 ist ein elektrochirurgisches, insbesondere bipolares medizinisches Instrument bekannt, das zwei Maulteile aufweist, von denen eines beweglich ist. Die beiden Maulteile weisen im Bereich ihrer gelenkigen Verbindung einen Grundkörper aus einem elektrisch isolierenden Material auf, an dem ein die zugehörige Elektrode bildender elektrisch leitender Maulteileinsatz befestigt ist. Die Stromzuführung zu der Elektrode des beweglichen Maulteils erfolgt über das zum Öffnen und Schließen der Maulteile vorgesehenes axial bewegliches Kraftübertragungselement, während die Elektrode des unbeweglichen Maulteils über ein gerade verlaufendes, drahtförmiges Element, das proximal mit dem ebenfalls als Stromzuführung dienenden Rohrschaft verbunden ist, und dessen distales Ende mit der Elektrode des unbeweglichen Maulteils verbunden ist.From the document WO-A-01/15614 an electrosurgical, in particular bipolar medical instrument is known, which has two jaw parts, one of which is movable. The two jaw parts have in the region of their articulated connection to a base body made of an electrically insulating material, to which a the corresponding electrode forming electrically conductive jaw part insert is attached. The power supply to the electrode of the movable jaw part via the provided for opening and closing of the jaws axially movable power transmission element, while the electrode of the stationary jaw part via a straight, wire-shaped element which is connected proximally to the likewise serving as a power supply tube shaft, and its distal end is connected to the electrode of the stationary jaw part.

Würde auch das zweite Maulteil beweglich ausgestaltet, bestünde das gleiche Problem wie bei dem zuvor beschriebenen bekannten Instrument, nämlich dass das drahtförmige Element permanent auf Biegung und Streckung beansprucht würde, was auf Dauer wiederum zu einem Bruch des drahtförmigen Elements führen würde.If the second jaw part were designed to be movable as well, the same problem would exist as with the known instrument described above, namely that the wire-shaped element would be permanently subjected to bending and stretching, which in turn would lead to breakage of the wire-shaped element.

Der Erfindung liegt daher die Aufgabe zu Grunde, ein medizinisches Instrument der eingangs genannten Art dahingehend weiterzubilden, dass die Lebensdauer des Instruments erhöht wird.The invention is therefore based on the object, a medical instrument of the type mentioned in such a way that the life of the instrument is increased.

Erfindungsgemäß wird diese Aufgabe hinsichtlich des eingangs genannten medizinischen Instruments dadurch gelöst, dass das drahtförmige Element im Bereich der Schwenkachse als Schleife ausgebildet ist.According to the invention, this object is achieved with regard to the above-mentioned medical instrument in that the wire-shaped element is formed in the region of the pivot axis as a loop.

Anstatt wie bei dem bekannten Instrument das drahtförmige Element im Wesentlichen geradlinig an dem die Schwenkachse bildenden Gelenk vorbeizuführen, ist bei dem erfindungsgemäßen medizinischen Instrument vorgesehen, das drahtförmige Element im Bereich der Schwenkachse zu einer Schleife zu legen, die einen Längenausgleich beim Verschwenken des zumindest einen beweglichen Maulteils um die Schwenkachse gewährleistet. Beim Hin- und Herverschwenken des zumindest einen beweglichen Maulteils beim Gebrauch des Instruments wird das drahtförmige Element somit nicht mehr permanent auf Biegung beansprucht, weil die permanente Winkeländerung des zumindest einen beweglichen Maulteils relativ zum Schaft an die Schleife weitergegeben und von dieser in eine Längenzunahme bzw. Längenabnahme am Umfang der Schleife umgewandelt wird. Die Schleife wirkt entsprechend wie eine Art Drehfeder.Instead of passing the wire-shaped element substantially straight on the joint forming the pivot axis, as in the case of the known instrument, it is provided in the medical instrument according to the invention to form a loop in the region of the pivot axis which compensates the length during pivoting of the at least one movable element Secured jaw part about the pivot axis. When swinging back and forth of the at least one movable jaw part when using the instrument, the wire-shaped element is thus no longer permanently subjected to bending, because the permanent change in angle of the at least one movable jaw part relative to the shaft passed to the loop and from this in a length increase or Length decrease is converted to the circumference of the loop. The loop acts like a kind of torsion spring.

In einer bevorzugten Ausgestaltung erstreckt sich die Schleife über zumindest etwa einen Halbkreis.In a preferred embodiment, the loop extends over at least about a semicircle.

Diese Maßnahme hat den Vorteil, dass die Gesamtlänge des drahtförmigen Elements gegenüber einem geradlinig geführten drahtförmigen Element nur geringfügig erhöht ist, und andererseits bei medizinischen Instrumenten, bei denen das zumindest eine bewegliche Maulteil nur einen geringen maximalen Schwenkwinkel durchläuft, ausreichend ist, um die erfindungsgemäße Wirkung wie oben beschrieben herbeizuführen.This measure has the advantage that the total length of the wire-shaped element is only slightly increased compared to a straight-line wire-shaped element, and on the other hand in medical instruments, in which the at least one movable jaw part passes through only a small maximum pivot angle, is sufficient to bring about the effect according to the invention as described above.

Besonders bevorzugt ist es, wenn sich die Schleife über zumindest einen Vollkreis erstreckt.It is particularly preferred if the loop extends over at least one full circle.

Bei dieser Ausgestaltung weist das drahtförmige Element zumindest eine vollständige Windung auf. Das proximale und das distale Ende des drahtförmigen Elements bilden bei dieser Ausgestaltung eine Art Schenkelfeder wie bei einer Wäscheklammer, wobei für die Zwecke der vorliegenden Erfindung eine Windung als Spiral- oder als Schraubenfeder ausreichend ist, es können jedoch auch mehr Windungen vorgesehen sein.In this embodiment, the wire-shaped element has at least one complete turn. The proximal and distal ends of the wire-shaped element in this embodiment form a kind of leg spring as in a clothespin, but for the purposes of the present invention one turn is sufficient as a spiral or coil spring, but more turns may be provided.

In einer weiteren bevorzugten Ausgestaltung ist die Schleife federelastisch.In a further preferred embodiment, the loop is resilient.

Dies kann vorteilhafterweise und vorzugsweise dadurch realisiert werden, dass das drahtförmige Element zumindest im Bereich der Schleife aus einem federelastischen Material, bspw. aus Federstahl, gebildet ist. Eine gewisse Federelastizität ergibt sich jedoch bereits durch die gebogene Konfiguration des drahtförmigen Elementes als Schleife und kann durch die zuvor genannte Materialwahl noch verstärkt werden. Die Federelastizität der Schleife kann vorteilhafterweise das Verschwenken des zumindest einen beweglichen Maulteils unterstützen, bspw. entweder die Öffnungsbewegung oder die Schließbewegung des zumindest einen beweglichen Maulteils.This can advantageously and preferably be realized in that the wire-shaped element is formed at least in the region of the loop of a resilient material, for example. From spring steel. However, a certain spring elasticity already results from the bent configuration of the wire-shaped element as a loop and can be enhanced by the aforementioned choice of material. The spring elasticity of the loop can advantageously support the pivoting of the at least one movable jaw part, for example, either the opening movement or the closing movement of the at least one movable jaw part.

In einer weiter bevorzugten Ausgestaltung ist die Schleife um die Schwenkachse herum angeordnet.In a further preferred embodiment, the loop is arranged around the pivot axis.

Während es im Rahmen der vorliegenden Erfindung auch vorgesehen sein kann, die Schleife distalseitig oder proximalseitig von der Schwenkachse anzuordnen, hat die vorstehend genannte Maßnahme den Vorteil, dass die Schleife an dieser Stelle ohne zusätzlichen Platzbedarf angeordnet werden kann. Der weitere Vorteil dieser Maßnahme besteht darin, dass das drahtförmige Element im Bereich der Schwenkachse am stärksten auf Biegung beansprucht wird, und somit der durch die Schleife bewirkte Längenausgleich am besten zum Tragen kommt.While it may be provided in the context of the present invention to arrange the loop distally or proximally from the pivot axis, the above measure has the advantage that the loop can be arranged at this point without additional space. The further advantage of this measure is that the wire-shaped element in the region of the pivot axis is subjected to the greatest bending stress, and thus the length compensation effected by the loop comes into its own.

In einer weiteren bevorzugten Ausgestaltung ist ein proximales Ende des drahtförmigen Elements am Rohrschaft festgelegt und leitend mit diesem verbunden.In a further preferred embodiment, a proximal end of the wire-shaped element is fixed to the tubular shaft and conductively connected thereto.

Diese Maßnahme hat den Vorteil, dass der Rohrschaft wie bei dem bekannten Instrument als Stromzuleitung genutzt werden kann. Das proximale Ende des drahtförmigen Elements kann dabei im Bereich des distalen Endes des Rohrschafts festgelegt werden, was den weiteren Vorteil hat, dass das drahtförmige Element nicht vollständig durch den Rohrschaft hindurch nach proximal geführt werden muss, was den Zusammenbau des erfindungsgemäßen Instruments vereinfacht.This measure has the advantage that the tubular shaft can be used as power supply line as in the known instrument. The proximal end of the wire-shaped element can be fixed in the region of the distal end of the tubular shaft, which has the further advantage that the wire-shaped element does not have to be guided completely through the tubular shaft to the proximal, which simplifies the assembly of the instrument according to the invention.

In einer weiteren bevorzugten Ausgestaltung ist am distalen Ende des Rohrschafts ein zweites bewegliches Maulteil angeordnet, das um die Schwenkachse verschwenkbar ist und eine zweite Elektrode aufweist, und ein axial bewegliches Kraftübertragungselement eines Betätigungsmechanismus zum Bewegen der beiden Maulteile dient als Stromzuleitung für die zweite Elektrode.In a further preferred embodiment, a second movable jaw part is arranged at the distal end of the tubular shaft, which is pivotable about the pivot axis and has a second electrode, and an axially movable force transmission element of an actuating mechanism for moving the two Jaw parts serves as power supply line for the second electrode.

Bei dieser Ausgestaltung kommen die vorteilhaften Wirkungen der vorliegenden Erfindung besonders zum Tragen, da für beide Elektroden der beiden beweglichen Maulteile eine Stromzuführung vorhanden ist, bei denen eine Biegebeanspruchung und damit eine Bruchgefährdung vermieden wird.In this embodiment, the advantageous effects of the present invention come into play especially since there is a power supply for both electrodes of the two movable jaw parts, in which a bending stress and thus a risk of breakage is avoided.

In diesem Zusammenhang ist es bevorzugt, wenn die beiden Maulteile im Bereich der Schwenkachse gegeneinander isoliert sind.In this context, it is preferred if the two jaw parts are insulated from each other in the region of the pivot axis.

Eine solche Isolierung kann wie bei dem aus dem Dokument WO-A-01/15614 bekannten Instrument vorgesehen sein, in dem die Maulteile, oder zumindest eines der beiden Maulteile, im Bereich der Schwenkachse einen Grundkörper aus einem elektrisch isolierenden Material aufweist. Dabei kann dann ein Niet oder Zapfen, der die Schwenkachse bildet, metallisch und damit besonders stabil ausgeführt werden, da über den isolierenden Grundkörper eine elektrische Trennung der beiden Maulteile voneinander bewerkstelligt ist.Such insulation may be provided as in the instrument known from document WO-A-01/15614 in which the jaw parts, or at least one of the two jaw parts, in the region of the pivot axis has a base body made of an electrically insulating material. In this case, then, a rivet or pin, which forms the pivot axis, metallic and thus be carried out particularly stable, since on the insulating body electrical separation of the two jaw parts is accomplished from each other.

Weitere Vorteile und Merkmale ergeben sich aus der nachfolgenden Beschreibung und der beigefügten Zeichnung.Further advantages and features will become apparent from the following description and the accompanying drawings.

Es versteht sich, dass die vorstehend genannten und die nachstehend noch zu erläuternden Merkmale nicht nur in der jeweils angegebenen Kombination, sondern auch in anderen Kombinationen oder in Alleinstellung verwendbar sind, ohne den Rahmen der vorliegenden Erfindung zu verlassen.It is understood that the features mentioned above and those yet to be explained below can be used not only in the particular combination given, but also in other combinations or in isolation, without departing from the scope of the present invention.

Ein Ausführungsbeispiel der Erfindung ist in der Zeichnung dargestellt und wird mit Bezug auf diese nachfolgend näher beschrieben. Es zeigen:

  • Fig. 1 ein medizinisches Instrument für die Elektrochirurgie in Seitenansicht; und
  • Fig. 2 das distale Ende des Instruments in Fig. 1 in vergrößertem Maßstab, teilweise im Längsschnitt.
An embodiment of the invention is illustrated in the drawing and will be described with reference to this in more detail below. Show it:
  • 1 shows a medical instrument for electrosurgery in side view; and
  • Fig. 2, the distal end of the instrument in Fig. 1 on an enlarged scale, partially in longitudinal section.

In Fig. 1 ist ein mit dem allgemeinen Bezugszeichen 10 versehenes medizinisches Instrument für die Elektrochirurgie dargestellt. In Fig. 2 sind weitere Einzelheiten des Instruments 10 näher dargestellt.In Fig. 1 is provided with the general reference numeral 10 medical instrument for electrosurgery. In Fig. 2, further details of the instrument 10 are shown in more detail.

Das Instrument 10 wird im Rahmen der minimal-invasiven Chirurgie zur Behandlung von Gewebe im menschlichen oder tierischen Körper zur Präparation mittels Hochfrequenzstrom verwendet.The instrument 10 is used in the context of minimally invasive surgery for the treatment of tissue in the human or animal body for preparation by means of high-frequency current.

Das Instrument 10 ist in dem gezeigten Ausführungsbeispiel ein Fassinstrument, genauer eine Fasszange, mit der Gewebe gefasst und koaguliert werden kann. Das Instrument 10 ist ferner ein bipolares Instrument, wie hiernach noch näher erläutert wird.The instrument 10 is in the embodiment shown a barrel instrument, more precisely a forceps, can be taken with the tissue and coagulated. The instrument 10 is also a bipolar instrument, as will be explained in more detail below.

Das Instrument 10 weist einen langerstreckten Rohrschaft 12 auf. Der Rohrschaft 12 ist ein als Stromleiter ausgebildetes metallisches Rohr, das von einer isolierenden Umhüllung umgeben ist.The instrument 10 has an elongate tubular shaft 12. The tubular shaft 12 is formed as a current conductor metallic tube, which is surrounded by an insulating sheath.

Am distalen Ende des Rohrschafts 12 sind ein erstes Maulteil 14 und ein zweites Maulteil 16 angeordnet.At the distal end of the tubular shaft 12, a first jaw part 14 and a second jaw part 16 are arranged.

Das erste Maulteil 14 und das zweite Maulteil 16 sind beide relativ zum Rohrschaft 12 um eine Schwenkachse 18 beweglich, das heißt verschwenkbar. In Fig. 1 sind die Maulteile 14 und 16 bezüglich ihrer Schließlage mit durchgezogenen Linien, und bezüglich ihrer Offenstellung mit unterbrochenen Linien dargestellt.The first jaw member 14 and the second jaw member 16 are both movable relative to the tubular shaft 12 about a pivot axis 18, that is pivotable. In Fig. 1, the jaws 14 and 16 are shown with respect to their closed position by solid lines, and with respect to their open position with broken lines.

Die Maulteile 14 und 16 sind im Bereich der Schwenkachse 18 an einem Isolatorstück 20 aus Kunststoff oder Keramik befestigt, das seinerseits mit dem Rohrschaft 12 verbunden ist.The jaw members 14 and 16 are mounted in the region of the pivot axis 18 on an insulator piece 20 made of plastic or ceramic, which in turn is connected to the tubular shaft 12.

Am proximalen Ende des Rohrschafts 12 ist eine Handhabe 22 angeordnet, die zwei Griffteile 24 und 26 aufweist. Die Griffteile 24 und 26 sind relativ zueinander um eine Schwenkachse 28 verschwenkbar gelenkig miteinander verbunden, wobei die Relativbewegung der Griffteile 24 und 26 dem Öffnen und Schließen der Maulteile 14 und 16 dient.At the proximal end of the tubular shaft 12, a handle 22 is arranged, which has two handle parts 24 and 26. The grip parts 24 and 26 are pivotally connected to each other pivotally about a pivot axis 28 relative to each other, wherein the relative movement of the handle parts 24 and 26 serves to open and close the jaws 14 and 16.

Des Weiteren ist an der Handhabe 22 ein Anschluss 30 zum Anschließen des Instruments 10 an einen nicht dargestellten Hochfrequenzstromgenerator angeordnet.Furthermore, a connection 30 for connecting the instrument 10 to a non-illustrated high-frequency current generator is arranged on the handle 22.

Der Rohrschaft 12 ist ferner um seine Längsachse verdrehbar, wozu zur Betätigung ein Drehgriff 32 am distalen Ende der Handhabe 22 angeordnet ist.The tubular shaft 12 is also rotatable about its longitudinal axis, for which purpose a rotary handle 32 at the distal end of the handle 22 is arranged for actuation.

Durch den Rohrschaft 12 verläuft von der Handhabe 22 zu den Maulteilen 14 und 16 ein axial bewegliches Kraftübertragungselement 34, das in Fig. 2 im Bereich seines distalen Endes dargestellt ist, und dessen proximales Ende mit einem der beiden Griffteile 24 bzw. 26 kraftschlüssig verbunden ist. Das Kraftübertragungselement 34 ist über einen Gelenkhebelmechanismus 36, 38, 40 mit beiden Maulteilen 14 und 16 verbunden. Eine axiale Bewegung des Kraftübertragungselements 34 dient dem Öffnen und Schließen, das heißt dem Verschwenken der Maulteile 14 und 16 um die Schwenkachse 18.Through the tubular shaft 12 extends from the handle 22 to the jaws 14 and 16, an axially movable force transmission element 34, which is shown in Fig. 2 in the region of its distal end, and the proximal end of one of the two handle parts 24 and 26 is positively connected , The Power transmission element 34 is connected via a toggle mechanism 36, 38, 40 with two jaws 14 and 16. An axial movement of the force transmission element 34 is used for opening and closing, that is, the pivoting of the jaws 14 and 16 about the pivot axis 18th

Die Schwenkachse 18 ist bspw. durch einen quer zur Längsrichtung des Schafts 12 verlaufenden Niet oder Achszapfen gebildet.The pivot axis 18 is, for example, formed by a transverse to the longitudinal direction of the shaft 12 extending rivet or journal.

Weiter mit Bezug auf Fig. 2 werden nun weitere Einzelheiten des Instruments 10 im Bereich der Maulteile 14 und 16 beschrieben.With further reference to FIG. 2, further details of the instrument 10 in the area of the jaws 14 and 16 will now be described.

Das Maulteil 14 weist eine Elektrode 42 auf, und das Maulteil 16 weist eine Elektrode 44 auf, wobei die Elektroden 42 und 44 das distale Ende der Maulteile 14 bzw. 16 bilden.The jaw part 14 has an electrode 42, and the jaw part 16 has an electrode 44, wherein the electrodes 42 and 44 form the distal end of the jaw parts 14 and 16, respectively.

Im proximalen Bereich weist das Maulteil 14 einen Grundkörper 46 aus isolierendem Material und das Maulteil 16 einen Grundkörper 48 ebenfalls aus isolierendem Material auf. Auf diese Weise sind die Maulteile 14 und 16 in ihrem proximalen Bereich elektrisch gegeneinander isoliert.In the proximal region, the jaw part 14 has a base body 46 made of insulating material and the jaw part 16 has a base body 48 also made of insulating material. In this way, the jaws 14 and 16 are electrically isolated from each other in their proximal region.

Als Stromzuleitung für die Elektrode 42 des Maulteils 14 dient ein drahtförmiges Element 50, dessen proximales Ende mit dem als Stromleiter ausgebildeten Rohrschaft 12 verbunden ist, bspw. im Bereich der in Fig. 1 mit dem Bezugszeichen 52 versehenen Stelle. Über den Rohrschaft 12 und das drahtförmige Element 50 kann die Elektrode 42 somit an einen ersten Pol des Hochfrequenzstromgenerators angeschlossen werden.As a power supply line for the electrode 42 of the jaw part 14 is a wire-shaped element 50, whose proximal end is connected to the formed as a current conductor tubular shaft 12, for example. In the area provided in Fig. 1 by the reference numeral 52 point. Via the tubular shaft 12 and the wire-shaped element 50, the electrode 42 can thus be connected to a first pole of the high-frequency current generator.

Ein distales Ende 54 des drahtförmigen Elements 50 ist mit der Elektrode 42 stromleitend verbunden.A distal end 54 of the wire-shaped element 50 is conductively connected to the electrode 42.

Im Bereich der Schwenkachse 18 ist das drahtförmige Element 50 als Schleife 56 ausgebildet, die um die Schwenkachse 18 herum angeordnet ist.In the region of the pivot axis 18, the wire-shaped element 50 is formed as a loop 56 which is arranged around the pivot axis 18 around.

Die Schleife 56 ist im vorliegenden Ausführungsbeispiel dadurch gebildet, dass das drahtförmige Element 50 etwa eineinhalb Mal um die Schwenkachse 18 herumgelegt ist, und somit zumindest eine Windung aufweist. Die Schleife 56 bewirkt beim Öffnen und Schließen des Maulteils 14 einen Längenausgleich, wobei das drahtförmige Element 50 dabei wesentlich geringer auf Biegung oder Streckung beansprucht wird.The loop 56 is formed in the present embodiment in that the wire-shaped element 50 is placed about one and a half times about the pivot axis 18, and thus has at least one turn. The loop 56 causes a length compensation during the opening and closing of the jaw part 14, wherein the wire-shaped element 50 is subjected to much less bending or stretching.

Während in dem gezeigten Ausführungsbeispiel die Schleife 56 sich somit über zumindest einen Vollkreis erstreckt, kann die Schleife 56 jedoch auch sich nur über zumindest etwa einen Halbkreis erstrecken, wenn dies den Anforderungen genügt.While in the embodiment shown the loop 56 thus extends over at least one full circle, however, the loop 56 may extend only over at least about one semicircle, if that satisfies the requirements.

Die Schleife 56 ist insbesondere federelastisch, wozu das drahtförmige Element 50 zumindest im Bereich der Schleife 56 aus einem federelastischen stromleitenden Material, insbesondere aus Federstahl, gebildet ist.The loop 56 is in particular spring-elastic, for which purpose the wire-shaped element 50 is formed, at least in the region of the loop 56, from a resilient, electrically conducting material, in particular from spring steel.

Die Elektrode 44 des zweiten Maulteils 16 wird demgegenüber über das Kraftübertragungselement 34, das entsprechend stromleitend ausgebildet ist, an den anderen Pol des Hochfrequenzgenerators angeschlossen, wobei die Stromübertragung vom Kraftübertragungselement 34 über den Gelenkhebelmechanismus 36, 40 erfolgt, wie dies in dem Dokument WO-A-01/15614 beschrieben ist, auf deren Offenbarung diesbezüglich ausdrücklich Bezug genommen wird.In contrast, the electrode 44 of the second jaw part 16 is connected to the other pole of the high-frequency generator via the force transmission element 34, which is correspondingly electrically conductive, the current transmission from the force transmission element 34 taking place via the toggle mechanism 36, 40, as described in the document WO-A -01/15614 is, the disclosure of which is expressly incorporated herein by reference.

Claims (9)

Medizinisches Instrument für die Elektrochirurgie, mit einem Rohrschaft (12), mit zumindest einem um eine Schwenkachse (18) relativ zum Rohrschaft (12) beweglichen Maulteil (14) am distalen Ende des Rohrschafts (12), wobei das zumindest eine bewegliche Maulteil (14) eine Elektrode (42) aufweist, und mit einer zu der Elektrode (42) des zumindest einen beweglichen Maulteils (14) führenden Stromzuleitung, die als drahtfömiges Element (50) ausgebildet ist, dessen distales Ende (54) mit der Elektrode (42) verbunden ist, dadurch gekennzeichnet, dass das drahtförmige Element (50) im Bereich der Schwenkachse (18) als Schleife (56) ausgebildet ist.A medical instrument for electrosurgery comprising a tubular shaft (12) having at least one jaw member (14) movable about a pivot axis (18) relative to the tubular shaft (12) at the distal end of the tubular shaft (12), the at least one movable jaw member (14 ) has an electrode (42), and with a current lead leading to the electrode (42) of the at least one movable jaw part (14), which is formed as a wire-shaped element (50) whose distal end (54) is connected to the electrode (42). is connected, characterized in that the wire-shaped element (50) in the region of the pivot axis (18) is designed as a loop (56). Instrument nach Anspruch 1, dadurch gekennzeichnet, dass sich die Schleife (56) über zumindest etwa einen Halbkreis erstreckt.An instrument according to claim 1, characterized in that the loop (56) extends over at least about a semicircle. Instrument nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass sich die Schleife (56) über zumindest einen Vollkreis erstreckt.Instrument according to claim 1 or 2, characterized in that the loop (56) extends over at least one full circle. Instrument nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Schleife (56) federelastisch ist.Instrument according to one of claims 1 to 3, characterized in that the loop (56) is resilient. Instrument nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, dass das drahtförmige Element (50) zumindest im Bereich der Schleife (56) aus einem federelastischen stromleitenden Material, insbesondere aus Federstahl gebildet ist.Instrument according to one of claims 1 to 4, characterized in that the wire-shaped element (50) at least in the region of the loop (56) of a resilient electrically conductive material, in particular made of spring steel. Instrument nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass die Schleife (56) um die Schwenkachse (18) herum angeordnet ist.Instrument according to one of claims 1 to 5, characterized in that the loop (56) is arranged around the pivot axis (18). Instrument nach einem der Ansprüche 1 bis 6, dadurch gekennzeichnet, dass ein proximales Ende des drahtförmigen Elements (50) am Rohrschaft (12) festgelegt und leitend mit diesem verbunden ist.Instrument according to one of claims 1 to 6, characterized in that a proximal end of the wire-shaped element (50) is fixed to the tubular shaft (12) and is conductively connected thereto. Instrument nach einem der Ansprüche 1 bis 7, dadurch gekennzeichnet, dass am distalen Ende des Rohrschafts (12) ein zweites bewegliches Maulteil (16) angeordnet ist, das um die Schwenkachse (18) verschwenkbar ist und eine zweite Elektrode (44) aufweist, und dass ein axial bewegliches Kraftübertragungselement (34) eines Betätigungsmechanismus zum Bewegen der beiden Maulteile (14, 16) als Stromzuleitung für die zweite Elektrode (44) dient.Instrument according to one of claims 1 to 7, characterized in that at the distal end of the tubular shaft (12) a second movable jaw member (16) is arranged, which is pivotable about the pivot axis (18) and a second electrode (44), and in that an axially movable force transmission element (34) of an actuating mechanism for moving the two jaw parts (14, 16) serves as a current feed line for the second electrode (44). Instrument nach Anspruch 8, dadurch gekennzeichnet, dass die beiden Maulteile (14, 16) im Bereich der Schwenkachse (18) gegeneinander isoliert sind.Instrument according to claim 8, characterized in that the two jaw parts (14, 16) in the region of the pivot axis (18) are insulated from each other.
EP05001771A 2004-07-02 2005-01-28 Medical instrument for electrosurgery Active EP1611858B1 (en)

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EP1611858B1 (en) 2011-04-06
DE502005011206D1 (en) 2011-05-19
US20060004355A1 (en) 2006-01-05
US7553311B2 (en) 2009-06-30
DE202004010780U1 (en) 2004-09-09

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